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Purpose Of Review: Coagulation management remains a challenge for anesthesiologists involved in cardiovascular surgery as the population undergoing surgery becomes older and presents with more comorbidities. These patients are frequently treated with one or more agents that directly affect coagulation. This review will discuss what is known and the treatments available to manage coagulation in the perioperative setting of cardiac surgery.
Recent Findings: New antithrombotics will be discussed as well as their proposed substitution in the preoperative period. The review will also describe the different products available in Europe for the treatment of bleeding and coagulopathy. Finally, the use of new monitoring devices will be discussed.
Summary: The introduction of new drugs with different mechanisms of action adds to the complexity of coagulation management during cardiovascular surgery. Monitoring needs to be developed and improved, especially for evaluating platelet function.
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http://dx.doi.org/10.1097/ACO.0b013e32834ef3d1 | DOI Listing |
Crit Care Explor
September 2025
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Objective: Vitamin C has been linked to alterations in platelet count and aggregation behavior. Given recent findings suggesting an association between vitamin C and adverse outcomes in patients with septic shock, we aimed to investigate whether vitamin C influences mortality in septic patients through its impact on platelets.
Design: Post hoc analysis of the Lessening Organ Dysfunction With Vitamin C (LOVIT) randomized trial (clinicaltrials.
Front Endocrinol (Lausanne)
September 2025
Department of Endocrinology and Nutrition, Hospital Clínico San Carlos Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Introduction: Dumping syndrome (DS) and postprandial hypoglycemia (PPH) are challenging complications encountered after Roux-en-Y gastric bypass (RYGB). Surgical revision is often the next therapeutic step when pharmacological and dietary treatments fail to control DS and PPH. Endoscopic argon plasma coagulation (APC) is a less invasive alternative that reduces the diameter of the gastrojejunal anastomosis (GJA).
View Article and Find Full Text PDFCureus
August 2025
Internal Medicine, Good Shepherd Hospital, Wayanad, IND.
Heyde's syndrome signifies the link between aortic stenosis (AS) and bleeding due to angiodysplastic changes. While colonic angiodysplasia is commonly implicated, gastric antral vascular ectasia (GAVE) represents a rarer manifestation in this context. We report the case of a 72-year-old male with severe AS who had recurrent upper gastrointestinal bleeding due to GAVE.
View Article and Find Full Text PDFCureus
August 2025
Respiratory Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Tuberculosis (TB) is a multisystem infectious disease with both pulmonary and extrapulmonary manifestations. TB can also induce a hypercoagulable state, setting off a cascade of changes in the body, including systemic inflammation, endothelial dysfunction, and abnormalities in the coagulation and fibrinolytic pathways. Collectively, these factors significantly increase the risk of venous thromboembolism, such as deep vein thrombosis and pulmonary embolism.
View Article and Find Full Text PDFBMJ Open
September 2025
Department of Orthopaedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Introduction: The management of bleeding and coagulation after total knee arthroplasty (TKA) has long been recognised as a significant challenge for orthopaedic surgeons. Despite the notable success of empirical anticoagulation in preventing venous thromboembolism (VTE) following TKA, the increased risk of postoperative bleeding has also raised extensive concern. Ecchymosis, as one of the most common manifestations indicating postoperative bleeding, holds the potential to indicate the balance of bleeding and hypercoagulation.
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